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General NPI Number Information
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NPI Number | 1891140323
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Entity Type | Organization
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Legal Business Name | LOWER MANHATTAN PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/03/2016
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 4 CORNWALL DR SUITE 220
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3332
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Country | US
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Telephone | 732-257-0900
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Fax | 732-257-5099
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Provider Business Mailing Address
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Address Line | 4 CORNWALL DR SUITE 220
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3332
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Country | US
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Telephone | 732-257-0900
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Fax | 732-257-5099
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Authorized Official
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Title or Position | PRESIDENT
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Name | SEAN W WATERS
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Credential | MSPT
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Telephone | 412-654-3212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 62024977
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License Number State | NY
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